ABSTRACT
The number of stumbling blocks along the road to recovery for both sufferer and clinician are many. On a societal level service availability (where can I get help?) is limited, as well as service accessibility due to waiting lists or demands set by treatment professionals (for example, minimum body mass index (BMI) for entry to a programme). In many countries service affordability or insurance reimbursement is also limited. On an individual level and in part due to the nature of eating disorders, on average, it takes an individual 4.2 years to recognize and acknowledge her disorder (patient delay). In our Dutch system, where the general practitioner serves as the gatekeeper to specialized care, doctor delay is 1.1 years on average (de la Rie et al. 2006). This may be attributed to the difficulty of diagnosing eating disorders and to a lack of training on eating disorders in many GPs. Also, patients often don't present their complaints and symptoms openly or they explicitly don't want to be referred for treatment. As a result only 50 per cent of sufferers with anorexia nervosa and approximately one in three sufferers with bulimia nervosa are detected in primary care (Keski-Rahkonen et al. 2007, 2009). Part 3 is devoted to specific subgroups of eating disorder sufferers, their barriers to care and specific needs in diagnosis and treatment.
